MARCH 12 was Youth Day and apart from it being a holiday most people were indifferent to this day.
Most of what you and I may recall of the day is that we did not have to go to work. We did not have to wake up early and suffer the slog of traffic all the way to work.
Or that for once we escaped the dread of meeting the boss in the corridor, when we were late, and having to make up another lie, for our tardiness.
There are so many holidays and special days that come and go leaving no significant difference in the way we live, except perhaps the opportunity to visit long forgotten relatives recently bereaved.
Some arguments arise about who the youth are and what age group they represent.
I will leave these arguments to those who are more expert in this than I am. For our purposes I will accept the older definition of youth as representing those people above 17 and less than 35 years.
This is the largest demographic group in Zambia, and makes up over 60 per cent of the total Zambian population.
Stated like that, it makes one sit up and take notice. So what are the major issues with this age group?
I am sure you will say youth unemployment, and perhaps you would be right.
From my perspective however, the bigger issue is how we can keep this group safe from disease.
You will ask the question, why this should be important.
Well, if the youth are healthy then the future of the country is secure and guaranteed. It sounds a little hollow, I know.
Like a statement politicians make when seeking re-election for a naïve electorate.
Think of it this way though. You are working hard to create a good future for yourself, but you are working even harder to make certain that your children have a better life than you did.
Replace the word youth, with “my children” then perhaps you will have caught the thinking better. So rephrasing, I would say the biggest issue with “our children” is not, will they have jobs?
The biggest question is, will they survive “youth hood” so that they will be healthy enough to work at all?
The biggest challenge of all is the undisputed fact that diseases are eating away at our greatest heritage, our grandchildren.
It is a fact that all over Africa, Zambia included, there has been a remarkable decline in our children’s ability to have children.
The biggest reason for this is the risk posed by sexual transmitted infections (STIs).
Notwithstanding our general indifference, it may be a good opportunity to ask what we can do about it.
We can begin by sounding an alarm and bringing some attention to these health problems.
1. What are the main health risks of the youth “our children”?
2. What dangers do these risks bring?
3. How can these risks be reduced?
Main health risks
of the youth
I was asked once to do a workshop with young people from the urban and peri-urban areas of Lusaka. The idea was to see what they know about health and what they do about it.
I learnt an important lesson; young people are more interested in each other than in anything else.
They were more excited about being brought together and it was hard to keep them focused on the topic.
The urban youth knew more than the peri-urban youth, but they both behaved the same.
The greatest health risks for the young people today are HIV and STIs.
These diseases are fuelled by early premarital sex, alcohol abuse, drug abuse, and smoking.
It also leads to a high rate of teenage pregnancies and very young single mothers.
These risks are no different from the risks all young people face in all generations. Why is this so? You might ask.
Well, putting it very basically, this is the time of development of their reproductive system and they will have a very strong reproductive drive.
This risk is more serious now because of the added problem of HIV infection. The highest prevalence of HIV in Zambia is among the youth.
New HIV infections are highest among the youth. The HIV prevalence among the youth is between 20 and 28 per cent, about twice the national average prevalence.
What is HIV and what are STIs? These subjects have been dealt with so frequently, that we are all probably suffering from “information fatigue” about them.
So I will spare you much of the detail and give a little bit of a different rendering, hoping I will hold your attention.
A distinction is often made between reproductive health and sexual health. When there was talk of privatising Zesco in the early 2000s, we heard about unbundling.
This meant that the functions of Zesco could be divided into three—generation, transmission and distribution (or delivery).
These functions could be seen as different and sold separately.
Keeping the concept of unbundling, we can then say reproductive organs are those that deal with generation and transmission, while sexual organs deal with distribution or delivery.
You might ask the question, if you are cheeky, delivery of what? Well just as Zesco delivers electrical units, so these systems delivery reproduction units (example, the egg or the sperm).
Given this understanding we can say STIs are those diseases which are spread only or mainly by sexual means.
HIV on the other hand is a disease spread mainly by sexual means, but also by blood transfusion or from a mother to her newborn baby.
The disease is caused by a small germ called a virus, which enters the defence system of the body (immune system).
Cleverly, it destroys the body’s defence system, rendering the body open to any germs that wish to attack the body.
How common are STIs in Zambia? The National AIDS Council indicates the STI prevalence in Zambia to be at eight to 10 per cent. STIs attack the distribution or delivery organs or, more simply, the sexual organs.
They cause three main problems initially. These are sores (ulcers),leakage (discharge)and swellings(lymph node enlargement).
HIV on the other hand causes two main problems which are infections by “opportunistic infections”, low-grade germs (particularly TB) and cancers of the reproductive system (in particular cancer of the neck of the womb-cervix). In men cancer of the manhood (cancer of the penis).
2. What dangers do these risks bring?
Many social problems will result from these health risks faced by the youth. However the most devastating of these is the damage to the reproductive system.
The countries of Africa in general and Zambia in particular are faced with the little recognised problem of male and female infertility.
What is infertility you might well ask? The World Health Organisation (WHO)defines it as the failure to have children inspite of consistent regular sexual intimacy in a couple over a period of at least 1 year.
The whole region of sub-Saharan Africa is termed the infertility belt because of the decline of fertility rates among the youth.
In Zambia over the last few years the ability of women to have children has declined from eight per woman in the 1960s to only 5.3 per cent children per woman in the 2014.
The Zambian population growth rate has fallen from 3.1 per cent in 1980 to 2.3 per cent in 2013.
It is also interesting to note that fertility rates are lowest in the Copperbelt and Lusaka provinces, where HIV prevalence and STIs are highest.
For the record, contraception usage rates are also low at about 49 per cent.
Put very bluntly, these diseases are depriving us of our grandchildren. You need only look at the newspaper column to see evidence of this.
The largest increase in advertising has been among traditional healers claiming to be able to cure problems around having children.
This has spilled out in the streets, and in many towns up and down the country you will find many women selling portions with presumed remedies for infertility.
There is nothing that makes parents happier than being surrounded by bouncy grandchildren in their old age. You and I are at risk of losing our posterity.
How do STIs
cause infertility?
We had spoken earlier about Zesco, and the generation, transmission and distribution of electrical units.
The germ that causes STIs produces a disruption in all three activities.
They will damage the reproductive organs (the ovaries and the testis) which produce (generation part) the reproductive units (eggs or sperms). They will also clog up the tubes (fallopian-female tubes and vas deferens-male tubes) which transmit them and also the sexual organ (which distributes them, so to speak).
However, the most frequent culprits are the tubes (fallopian and the vas deferens) which usually close off, resulting in non-transmission of the reproductive units to allow for fusion of the egg and sperm(fertilisation).
The result of this blockage is the failure to have children.
Unfortunately, these diseases do not only stop at causing our children to become infertile, they travel through the reproductive and sexual organs causing other diseases, the most fatal of which is cancer.
How does this disease do this? The combination of low defence cells in the body and increases in viruses (small germs- the Human Papilloma Virus) that damages the reproductive body cells lead to cancers.
These viruses enter the nucleus (the cells central control unit), and here they interfere with the encoding system (DNA) which controls and regulates cell growth and development.
This leads to a loss of control of cell growth. This in turn leads to cancer. Cancer as is well known is a condition in which normal control of growth of the cells is lost.
Abnormally growing cells overgrow their boundaries and invade and destroy neighbouring cells.
In particular the common cancers are cancer of the neck of the womb (cancer of the cervix) and cancer of the male organ (cancer of the penis).
How can these risks
be reduced?
There are a few social vices that promote or fuel STIs and HIV infection among the youth. A number of studies have shown an increase in teenage smoking and drinking among the youth, particularly starting in the lower secondary school classes of grade eight and nine.
So our responsibility as parents is to educate our children about these risks while they are still in primary school. This responsibility must rest with the parent.
The school, church and grandparents cannot be used as surrogate parents.
Schools and the church can only support and reinforce what we are already doing in the home.